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6 December 2006

Cooksey proposes reform of medical research

Sir David Cooksey today published his review of the institutional arrangements for the public funding of health research in the UK. The review argues that considerable progress has been made in some areas, notably NHS R&D, in the last few years and sets out recommendations to ensure that publicly funded health research is carried out in the most effective and efficient way, facilitating rapid translation of research findings into health and economic benefits.

Speaking at the launch of his review, Sir David Cooksey said:

"This review seeks to build on the outstanding record of the UK in basic health research and the fundamental changes that are taking place in health service Research & Development. I have proposed a package of measures to help the UK health profession to develop and deliver better therapies for patients. My proposals also seek to build on the UK's position as a world leader in science and innovation, especially in life science, to further enhance productivity and economic development."

Key recommendations set out in the review include:

The establishment of the Office for Strategic Coordination of Health Research (OSCHR) to act as a central coordinating body for health research.

Reporting to the Department of Health and the Office of Science and Innovation, and with structures to allow strategic input from the devolved administrations, OSCHR would:

  • Set the government's health research strategy, taking into account the advice, priorities and needs set out by the National Institute of Health Research (NIHR) and its counterparts in the devolved administrations, the Medical Research Council (MRC) and the NHS;
  • Set the budget required to deliver this strategy and submit a single Spending Review bid to the Treasury;
  • Communicate the UK's health priorities to the pharmaceutical and bioscience sectors, including designating public and private sector projects addressing hitherto unmet health needs as 'UK Priority Projects';
  • Monitor delivery of the strategy against objectives and report to Parliament on progress; and
  • Encourage a stronger partnership between Government, health industries and charities.

The Creation of a joint MRC/NIHR Translational Medicine Funding Board

The new funding board would consist of representatives from the MRC, NIHR, healthcare industries, DH, DTI and devolved administrations. It would:

  • Take the lead in developing a translational research strategy to maximize the economic and health benefits of innovation; and
  • Through sub-boards, be responsible for allocation of both response mode and targeted calls for research relating to the translational research strategy.

Spurring innovation

Enhancing drug development and the uptake of clinically- and cost-effective new technologies by:

  • Supporting a more pro-active approach in the NHS to the uptake of cost-effective new ideas and technologies, in keeping with the Wanless Report, including examining the case for further investment in Health Technology Assessment (HTA) in the Comprehensive Spending Review; and
  • Creating a new partnership between government, regulators and industry to pilot a new drug development 'pathway' to create wins for all stakeholders: industry, government, the wider economy and, most importantly, patients.

MRC / NIHR

  • MRC should retain essentially the same institutional structures as it has now.
  • The National Institute for Health Research (NIHR) should become a real, rather than a virtual institute, established as an Executive Agency of the Department of Health by April 2009.
  • Under the new arrangements, there should be a much clearer demarcation of responsibilities between MRC and NIHR.
  • Current funding levels for basic science should be sustained. However, future increases in funding should be weighted towards translational and applied research until a more balanced portfolio is achieved (as judged by OSCHR).

The Report's recommendations build on recent Government action including the creation of the UK Clinical Research Collaboration to improve the infrastructure for clinical and medical research; the creation of the Joint MRC/NHS Health Research Delivery Group in the 2004 Spending Review to enable a more joined-up approach between Government funders of medical and clinical research; the creation of a new strategy for research in the NHS in England, Best Research for Best Health; and the establishment of MRC Technology, to manage and commercially develop intellectual property arising from the basic research carried out by the MRC's directly-supported scientists.

The recommendations address:

  • The need for an overarching health research strategy to ensure UK health priorities are considered through all types of research;
  • The cultural, institutional and financial barriers to translating research into practice that continue to exist in the publicly funded research arena;
  • The increasing challenges facing industry in translating research into health and economic benefit;
  • The need for the NHS to develop a more positive culture to support research, although the announcement in Budget 2006 that the DH R&D budget will be ring-fenced and the reforms set out and being implemented under Best Research for Best Health are important steps in achieving this cultural change;
  • The current unsystematic approach to the adoption of new technologies and interventions in the NHS, which can make assessment of their efficacy and cost-effectiveness problematic, and in turn result in low rates of adoption and diffusion of cost effective new technologies and interventions; and
  • New ways of bringing drugs that address UK health priorities to market faster, without compromising patient safety.

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Notes to editors

1. The Chancellor of the Exchequer invited Sir David Cooksey to review the design and institutional arrangements of the public funding of health research in the UK. This followed the Chancellor's announcement in the budget for a single, ring-fenced budget to support the health research funded by the Medical Research Council and the NHS R&D Programme. Today, Sir David reported to the Chancellor of the Exchequer, Gordon Brown, the Secretary of State for Health, Patricia Hewitt, and the Secretary of State for Trade and Industry, Alastair Darling.

2. The Review was commissioned to advise on the best design and institutional arrangements for public funding of health research in the UK, taking account of:

  • health objectives - ensuring research priorities are firmly grounded in the Government's wider health objectives, national and international, and that health research is rooted in, and a key priority for, the NHS;
  • science objectives - ensuring the continued delivery of world class basic science, according to the long-standing Haldane principle which states that day-to-day decisions on Research Council scientific funding must be taken at arms length from ministers. Funding should continue to be awarded on the basis of excellence across the full spectrum of health research, from basic to clinical and public health. This will include continued support for investigator-led research; and
  • economic objectives - ensuring the delivery of high-quality translational health research to deliver real economic, as well as health benefits, from the UK's excellent science base.

3. In arriving at these conclusions, the Review consulted widely, both in the UK and abroad, meeting a wide range of stakeholders. The public consultation announced on 4 May 2006 formed an important part of the review - just under 300 responses were received (copies of responses received will be available on the website from Monday 11 December). In addition a one day stakeholder meeting was hosted by the Academy of Medical Sciences and the Royal Society in July 2006.

4. The analysis carried out for the review concludes that the UK system of health research has many strengths. The UK has a long tradition of producing excellent basic science, with the Medical Research Council (MRC) funding 27 Nobel prize winners since its establishment in 1913. The quality of the health research base, combined with a national health service, creates a major selling point that attracts R&D investment from the pharmaceutical and biotechnology industries, which form a major part of the UK knowledge economy.

5. A copy of the report and supporting documentation are available at the Treasury website.

6. Sir David Cooksey is Chairman of the UK Clinical Research Collaboration Industry Reference Group, Chairman of the Joint Health Research Delivery Group and is Chairman of London & Continental Railways Ltd. David has recently retired as Chairman of Advent Venture Partners, which he founded in 1981. He was also the first Chairman of the British Venture Capital Association in 1983/84 and was Chairman of the European Private Equity & Venture Capital Association for 2005/6.

7. Media enquiries - including media bids for David Cooksey - should be addressed to the Treasury Press Office on 020 7270 5238. Non-media enquiries should be addressed to the Treasury Correspondence and Enquiry Unit on 020 7270 4558.

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